Abstract
Background: Traumatic brain injury is a common condition in neurosurgery. Traditional methods of treatment include conservative treatment and surgical evacuation using burr-holes or craniotomy; however, studies have reported problems such as high re-expansion rates after conservative treatment of epidural hematoma and high postoperative recurrence rates of subdural hematoma. Solutions to these problems are lacking, and research into new treatment methods is ongoing. Among the potential new treatments, middle meningeal arterial embolization is an option. This study involved patients with acute epidural hematoma and chronic subdural hematoma. The purpose was to evaluate the use and effects of absolute alcohol to embolize the middle meningeal artery to treat intracranial hematoma.Material and Methods: A retrospective description study was 12 cases of intracranial hematoma who treated with absolute alcohol interventional therapy from our hospital between June 2018 and October 2019. Five patients with acute epidural hematoma and seven patients with chronic subdural hematoma were treated using absolute alcohol to embolize the middle meningeal artery. Patients' clinical data, imaging results, surgical results, and prognosis were recorded and analyzed.Results: All patients underwent absolute alcohol embolization of the middle meningeal artery, in combination with burr-hole drainage. All imaging data were confirmed preoperatively. We successfully used absolute alcohol to embolize the middle meningeal artery intraoperatively and confirmed these results by postoperative angiography. All patients achieved symptomatic relief without complications, and no recurrence or re-expansion was seen with follow-up computed tomography. Our study has been registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn, ChiCTR1800018714).Conclusion: The use of absolute alcohol to embolize the middle meningeal artery could be used as an attempt to treat acute epidural hematoma and chronic subdural hematoma.
Highlights
Traumatic brain injury is a common neurosurgical condition, and it often causes traumatic intracranial hemorrhage (TICH) [1]
Several studies reported a rate of re-expansion of acute small epidural hematomas after conservative treatment of 23 to 65% [10, 11], and some studies report a postoperative recurrence rate for Chronic subdural hematoma (CSDH) of 0.35 to 23% or higher [12, 13]
We report the successful use of middle meningeal artery (MMA) embolization with absolute alcohol to treat intracranial hematoma in 12 patients: five patients with Acute epidural hematoma (AEDH) and seven patients with CSDH
Summary
Traumatic brain injury is a common neurosurgical condition, and it often causes traumatic intracranial hemorrhage (TICH) [1]. Absolute alcohol is the liquid sclerosing agent most often used because of its low cost, wide availability, and ease of use. Traditional methods of treatment include conservative treatment and surgical evacuation using burr-holes or craniotomy; studies have reported problems such as high re-expansion rates after conservative treatment of epidural hematoma and high postoperative recurrence rates of subdural hematoma. Solutions to these problems are lacking, and research into new treatment methods is ongoing. The purpose was to evaluate the use and effects of absolute alcohol to embolize the middle meningeal artery to treat intracranial hematoma
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